Equipment problems

This chapter provides the reader with logical guidelines and checklists to investigate and quickly correct problems with anaesthetic equipment. The anaesthetist is dependent on the smooth and correct functioning of the necessary equipment, and this chapter explains some of the issues that may be encountered. The areas covered are: leaks in the anaesthetic breathing circuit, ventilator failure, oxygen supply failure, theatre power failure, and causes of high airway pressure. Each problem is addressed by firstly its definitions, presentation, investigations, risk factors, and exclusions; then how it can be managed in the immediate, medium-, and long-term situations. Finally, any special considerations are outlaid, followed by a list of further reading.

Anaesthesia Equipment and Utilities

The chapter covers anaesthetic equipment that may not be familiar to anaesthetists practising in high-resource settings. Primarily this means draw-over anaesthesia equipment—recognition, set-up, usage in adults and children, and practical tips. How to maintain your equipment yourself so that it continues to function safely is covered. The chapter also considers the two basic utilities of anaesthetic practice that are often taken for granted in high-resource settings—oxygen and electricity—and how to cope with an unpredictable supply of both. Hygiene and sterilization, a responsibility that often falls to the medical team in resource-poor settings, is also covered with practical advice on how to do it yourself.

The Nagin Parbhoo History of Anaesthesia Museum – Part 1

This paper provides a brief history of the Nagin Parbhoo History of Anaesthesia Museum housed in the University of Cape Town Department of Anaesthesia and Perioperative Medicine and introduces readers to the contents of the museum. Artifacts are contextualised and demonstrate the vast changes that have taken place in the specialty from the early days of ‘rag and bottle’ anaesthesia in the 1840s to the present. The role of a medical museum in preserving the history of the specialty, encouraging research and in using artifacts to teach physical principles relating to anaesthetic equipment is discussed. A follow-up paper will document the history of the museum.

The Nagin Parbhoo History of Anaesthesia Museum – Part 1

This paper provides a brief history of the Nagin Parbhoo History of Anaesthesia Museum housed in the University of Cape Town Department of Anaesthesia and Perioperative Medicine and introduces readers to the contents of the museum. Artifacts are contextualised and demonstrate the vast changes that have taken place in the specialty from the early days of ‘rag and bottle’ anaesthesia in the 1840s to the present. The role of a medical museum in preserving the history of the specialty, encouraging research and in using artifacts to teach physical principles relating to anaesthetic equipment is discussed. A follow-up paper will document the history of the museum.

Anaesthetic equipment

This chapter presents anaesthetic equipment used in paediatric anaesthesia. Airway equipment is described in detail with specific examples. This includes a description of the variety of supraglottic airway devices, endotracheal tubes, laryngoscopes for direct and indirect visualization of the larynx, breathing systems, ventilators, and modes of ventilation. Equipment for perioperative monitoring of the paediatric patient is reviewed. Practical advice regarding monitoring neonates and small babies is given particular attention. The use of the bispectral index (BIS) monitor and near-infrared spectroscopy (NIRS) are discussed. New advances in pulse oximetry that enable better monitoring with low perfusion states and motion are included.